運動訓練對血液透析病患之成效

Effects of Exercise Training on Hemodialysis Patients

本研究目的在探討運動訓練對血液透析病患運動耐力、血液生化值、疲憊與內控型健康控制歸因之成效。採類實驗研究方法，以立意取樣方式選取南部某醫學中心的血液透析病患有效樣本共40位，按其意願分派至實驗組與控制組各20位。實驗組於非洗腎期進行每週三次，每次約30~50分鐘，為期八週踩固定式腳踏車的運動訓練。實驗組於運動訓練前與運動訓練八週後及控制組於對照八週後分別評估其運動耐力、抽血檢驗血液生化值、填寫疲憊評量表及內控型健康控制歸因量表。所得資料以卡方檢定、t檢定及重複量數雙因子變異數分析(repeated measures two-way ANOVA)等方法進行分析。結果顯示運動訓練能顯著改善病患的運動耐力、降低血中的三酸甘油脂與膽固醇檢驗值及減輕疲憊感，而在紅血球、血色素、血球容積、低密度脂蛋白、高密度脂蛋白與血糖之檢驗值及內控型健康控制歸因未有顯著差異。本研究結果可提供腎臟復健課程設計之參考，並可將運動訓練整合進入臨床照護中，以提昇血液透析病患之照護品質。

The purpose of this quasi-experimental study was to explore the effects of exercise training on the exercise capacity, blood biochemical data, fatigue and internal health locus of control of hemodialysis patients. A total of 40 hemodialysis patients were assigned to exercise training(n=20) and control(n=20) groups. For 8 weeks, the experimental group performed stationary bicycle exercise training on off-dialysis three times a week and 30~50 minutes each time while the control group did not receive any instruction related to exercise. Before and after receiving the 8-week exercise training, each subject was required to complete the Fatigue Scale and the Internal Multidimensional Health Locus of Control Scales questionnaires. The Patient's exercise capacity and blood biochemical data were also collected. The data were analyzed by using chi-square, t-test and repeated measures two-way ANOVA. Results of the study showed that exercise training significantly improved exercise capacity, reduced fasting plasma triglyceride and total cholesterol level, and decreased fatigue. However, no significant differences were found for red blood cell, hemoglobin, hematocrit, fasting plasma low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, serum glucose level and internal health locus of control. The findings may serve as a reference for renal rehabilitation, and suggest that exercise training for hemodialysis patients could be incorporated in the clinical practice to enhance the quality of care.